Information technology for doctors

Recent advances in information technology will offer clinicians valuable new tools to support the medical management of patients. The most important of these developments is the electronic health-care record itself, which will enable the quick and complete documentation of all clinical consultations, investigation and interventions, using voice or a pen to enter data onto intuitive graphical screen-interfaces. The next generation of systems will offer computerised decision support for a wide range of clinical management problems.

A portable communicative architecture for electronic healthcare records: the Good European Healthcare Record project (Aim project A2014)

The European Union is supporting research into medical informatics via its Advanced Informatics in Medicine (AIM) program. One of the current AIM projects is the Good European Healthcare Record (GEHR) project. Its objective is to devise an architecture for electronic healthcare records that will enable them to be comprehensive, communicative, and portable to different systems. The work was funded from January 1992 to December 1994. The project team consisted of over 50 personnel representing clinicians, computer scientists, and computer programmers in eight European countries. The partner organizations are Health Data Management Partners (Belgium), Croix Rouge Francaise (France), France Telecom, Association des Medecins et Medicins Dentistes (Luxembourg), Instituto Clinica Geral Zona Norte (Portugal), Medical College of St Bartholomew's Hospital (UK), and SmithKline Beecham (UK). The work of the project has been carried out by three subgroups covering clinical, architecture, and systems aspects. One of the strengths of the project has been that most of the work has been done as collaborations between members of different groups. This has meant that there has been very close contact between clinicians and computer experts. The GEHR project is providing important input into the standardization process in Europe via, for example, PT011 of Working Group 1 of CEN TC/251 (the developing standards for the architecture of healthcare records).

Electronic health records: the European scene

Caring for patients' health problems relies increasingly on sharing information between clinical departments and disciplines and with managers. The medical record of the future will need to provide a flexible and shareable framework for recording and analysing the consultation process. The advanced informatics in medicine (AIM) programme seeks to encourage research and development in telemedicine in areas that are beyond the scope of any one country. It includes many European projects attempting to define the best storage and transmission formats for such diverse data types as laboratory results, biosignals, x ray images, and photographs, and in clinical specialties varying from intensive care to medicine for elderly people. One example, the good European health record project, is developing a model architecture for computerised health records across Europe that is capable of operating on a wide variety of computer hardwares and will also be able to communicate with many different information systems. The ultimate European health record will be comprehensive and medicolegally acceptable across clinical domains, hold all data types, and be automatically translated between languages.

Guaranteed ray intersections with implicit surfaces

In this paper, we present a robust and mathematically sound ray-intersection algorithm for implicit surfaces. The algorithm is guaranteed to numerically find the nearest intersection of the surface with a ray, and is guaranteed not to miss fine features of the surface. It does not require fine tuning or human choice of interactive parameters. Instead, it requires two upper bounds: "L" that limits the net rate of change of the implicit surface function f(x,y,z) and "G" that limits the rate of change of the gradient. We refer to an implicit surface with these rate limits as an "LG-implicit surface."Existing schemes to intersect a ray with an implicit surface have typically been guaranteed to work only for a limited set of implicit functions, such as quadric surfaces or polynomials, or else have been ad-hoc and have not been guaranteed to work. Our technique significantly extends the ability to intersect rays with implicit surfaces in a guaranteed fashion.

Horseshoe kidney in one of identical twin girls

We report on a 5-month-old female twin who presented with urinary tract infection and was found to have a horseshoe kidney. Her identical twin had a normal renal anatomy. There have been only 2 other reports of a horseshoe kidney in monozygotic twins: in 1 instance both twins were affected, while in the other there was discordance.

Comparison of blood glucose test strips in the detection of neonatal hypoglycaemia

Blood glucose levels were estimated in 101 neonatal blood samples using three glucose test strip methods and the results compared with those from a laboratory. BM-test-glycemie 20-800 test strips and Reflotest-hypoglycemie test strips gave a rapid and reliable estimate of blood glucose level in the range 0-8 mmol/l (0-140 mg/100 ml). Dextrostix test strips tended to overestimate all blood glucose levels.